by Marion Nestle

Currently browsing posts about: Supplements

Dec 24 2020

Using the pandemic as a business opportunity, European version

Food Safety News reports that the European Commission is getting increasingly upset about fraudulent claims that specific food and supplement products will boost immunity and help protect against Covid-19 or even cure it.

Alas, they will not.

The EC is worried about online advertisements.  Food Safety News reported more than 350 cases of such claims in June.  Now there are even more.

In the US, we mostly see this sort of thing—websites from the supplement industry telling you to take supplements.  Here  is what this one claims, with my comments in red.

Supplements can help you address nutrient insufficiencies or deficiencies in your diet—but can they help you fight COVID-19? Not as far as anyone knows.

While there hasn’t been specifically-targeted research to determine which—if any—nutrients should be FDA-approved to ward off the virus, [Indeed] supplements are an ideal way to keep your body and your immune system functioning at optimal levels. No, they are not.  Food works much better.

As a result, many physicians and other health and wellness experts recommend beginning a simple supplement routine to ensure your body has the nutrients it needs to stay healthy.  Many others do not, and neither do I.…The supplements you take during the COVID-19 pandemic may not be specifically developed to ward off the coronavirus. Right.  So don’t expect them to work.

Still, research has shown that they all play an important role in boosting the immune system, preventing respiratory damage, strengthening the body against viral infections, reducing inflammation—or all of the above.  This is true, but largely in experimental studies likely to have been funded by the supplement industry.

Obviously, I am not a fan of supplements.  There just isn’t much evidence that they do anything useful for healthy people, and healthy people are the ones most likely to be taking them.

With respect to Covid-19, the best preventive strategy is avoidance (masks, distancing, etc).

The best immune-boosting strategy is to eat a healthy diet–largely (but not necessarily exclusively) plant-based, balanced in calories, and with minimal amounts of ultra-processed junk foods.

And let’s all hope the vaccination comes soon and works like a charm.

Happy holidays.

Dec 10 2020

Some odd items, just for fun

I’ve been collecting intriguing items about new foods and supplements, soon to be at a supermarket near you.

Nov 30 2020

Industry-funded nutrition-and-Covid advice: take our supplements!

I’m always interested in how food, beverage, and supplement companies are taking advantage of fears of Covid-19 to sell their products.

The supplement company. Nutricia, has produced a report, Learnings from a Global Pandemic: The Role of Nutrition in COVID-19 Recovery and the Ongoing Pursuit of Healthy Aging 

The logic of this report goes:

  • Covid-19 disproportionally affects older adults.
  • Healthy immune systems help prevent bad outcomes.
  • Nutrition is important for a healthy immune system.

No argument there.  At issue is how to have a healthy immune system.

A wealth of mechanistic and clinical data21 show that beyond protein and energy, vitamins (including A, B6, B12, C, D, E, and folate) and trace elements (zinc, iron, selenium, magnesium, and copper) and omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) play important and complementary roles in supporting the immune system. Inadequate intake of these nutrients can lead to a decrease in resistance to infections and as a consequence an increase in disease burden.

Therefore, the question is how to get these nutrients.  I vote for food.  Nutricia, no surprise, has another suggestion, especially for hospitalized patients:

Treatment should continue after hospital discharge with ONS [oral nutritional supplements] and individualized nutritional plans.

Nutricia is owned by Danone.  Danone announced this week that  it is cutting 2000 jobs to save more than a billion dollars.

As the pandemic continues to surge, the yogurt and beverage giant has been impacted by the closure of restaurants and other venues that reduced demand for its water, a reduction of SKUs [stock keeping units] offered by its retail partners and a drop in the number of births that has curtailed consumption of its baby formula products.

One solution: sell more supplements, and use Covid-19 to do so.

Will supplements protect against catching Covid-19 or experiencing its worst symptoms?  I’m waiting for the data.

I still think it’s healthier to get nutrients from foods.

Sep 28 2020

Industry-sponsored studies of the week: two on omega-3 supplements

I.  Expert Opinion on Benefits of Long-Chain Omega-3 Fatty Acids (DHA and EPA) in Aging and Clinical Nutrition, Troesch B, et al.  Nutrients 2020;12(9):2555.

Conclusion: The evidence to date indicates that the provision of DHA and EPA through capsules, oral nutrition supplements, or enteral or parenteral formulas can help to regulate the inflammatory environment in a number of medical conditions and that this is linked in many cases to improved function, clinical course and outcomes.

Funding: DSM Nutritional Products Ltd. provided financial support to organize and invite experts to participate as discussants, based on their expertise on the role of DHA and EPA in aging as well as different medical conditions, as well as financial support for the development of this review.
Conflicts of Interest: B.T. and I.W. are employed by DSM Nutritional Products Ltd.; M.E. acts as an advisor for DSM, received travel reimbursement from DSM and is a member of the Scientific Board of PM International and President of the Gesellschaft für angewandte Vitaminforschung; A.L. received consulting fees from BBraun, DSM, Nutricia and Smartfish and received honoraria for independent lectures from Abbott, Baxter, BBraun, Fresenius Kabi, Nestlé Health Science, Nutricia and Smartfish; Y.R. received travel reimbursement from DSM; AW receives speaker fees from Baxter Germany, Berlin Chemie, BBraun Melsungen AG, DSM, Ethicon, Falk Foundation Fresenius Kabi Deutschland GmbH, Medtronic and research grants from Baxter, Danone and Mucos; P.C.C. acts as a consultant for DSM, BASF, Danone/Nutricia, Cargill, Smartfish and Fresenius Kabi. A.D.S. has no conflict to declare.
Comment: DSM Nutrition Products is a major seller of dietary supplements, with a highly vested interest in demonstrating the benefits of the supplements it sells.  Evidence on the benefits of omega-3 fatty acid supplements tends to vary enormously.  Some studies, like this one, find benefits.  Other studies do not (see, for example, this, this, or this).  Could funding source have something to do with these differences?  I think yes.  
Before I had a chance to post this one, a reader, Dr. Eliška Selinger, who teaches science methods and nutrition in Prague, sent yet another example, this one not yet published.II.  Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Aldo A. Bernasconi, PhD; Michelle M. Wiest, PhD; Carl J. Lavie, MD; Richard V. Milani, MD; and Jari A. Laukkanen, MD, PhD.  Article in press Mayo Clin Proc. n XXX 2020;nn(n):1-10 n https://doi.org/10.1016/j.mayocp.2020.08.034

Objectives: “To quantify the effect of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids on cardiovascular disease (CVD) prevention and the effect of dosage.”

Conclusion: “Cardiovascular disease remains the leading cause of death worldwide. Supplementation with EPA and DHA is an effective lifestyle strategy for CVD prevention, and the protective effect probably increases with dosage.”

Potential Competing Interests: “Dr Bernasconi is an employee of the Global Organization for EPA and DHA Omega-3s (GOED), a 501(c)6 not-for profit trade association. GOED’s goals are to increase consumption of omega3s to adequate levels around the world and to ensure that the industry is producing quality omega-3 products that consumers can trust. Dr Wiest has been a guest speaker with travel sponsored by DSM Nutritional Products and the Global Organization for EPA and DHA Omega-3s (GOED); and has received funding from GOED to conduct a meta-analysis on omega-3 fatty acids. Dr Lavie has been a speaker for Amarin Corporation on Vascepa, has consulted for DSM Nutritional Products, and has made an omega-3 educational video at the American Heart Association meeting on November 14, 2016, for the Global Organization for EPA and DHA Omega-3s and also gave a presentation at a GOED-hosted omega-3 conference in Barcelona, Spain, in February 2020. The remaining authors report no potential competing interests.”

Grant Support: “This study was supported by a grant from the Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, UT.”

Comment: The Global Organization for EPA and DHA Omega-3s “represents the worldwide EPA and DHA omega-3 industry…Our mission is to increase consumption of EPA and DHA omega-3s…”   Omega-3 fatty acids are essential to human health and are widely available from green leafy vegetables (in the form of ALA) as well as from fish (EPA and DHA).   ALA is converted in the body to EPA and DHA.   The benefits of omega-3 supplements, as I just explained, are not well established.  This trade association for EPA and DHA supplements funded this study to demonstrate the benefits of these products.  Caveat emptor.

Aug 3 2020

Dubious health claim of the week: cranberries and UTIs

The FDA has just announced a Qualified Health Claim for Certain Cranberry Products and Urinary Tract Infections.

The U.S. Food and Drug Administration announced today in a letter of enforcement discretion that it does not intend to object to the use of certain qualified health claims regarding consuming certain cranberry products and a reduced risk of recurrent urinary tract infection (UTI) in healthy women.

Huh?

The FDA does not exactly approve health claims that are not backed up by scientific evidence.  It just doesn’t object to them.

This one, no surprise, comes in response to a request by Ocean Spray Cranberries, Inc, which would love to be able to market its products as helping to prevent UTIs (which lots of people believe).

Here’s what the FDA says about the science.

After reviewing the petition and other evidence related to the proposed health claim, the FDA determined that the scientific evidence supporting the claim did not meet the “significant scientific agreement” standard required for an authorized health claim.

Hence, the Qualified health claim.

If Ocean Spray wants to use the claim, it has to put atatements like these on the label:

  • For cranberry juice beverages: “Consuming one serving (8 oz) each day of a cranberry juice beverage may help reduce the risk of recurrent urinary tract infection (UTI) in healthy women. FDA has concluded that the scientific evidence supporting this claim is limited and inconsistent.”
  • For cranberry dietary supplements: “Consuming 500 mg each day of cranberry dietary supplement may help reduce the risk of recurrent urinary tract infection (UTI) in healthy women. FDA has concluded that there is limited scientific evidence supporting this claim.”

Why does Ocean Spray want this?  Because believers will ignore the FDA disclaimers.  Ocean spray says:

To that end, Ocean Spray will use its medical attributes in the place they matter most–running a campaign on the WebMD site later this year. “We’re going to be all over WebMD,” he said, noting that the connection between cranberry juice and urinary tract health is the fifth most discussed topic on the influential health site.

Qualified health claims are about marketing, not science.

But I know how you feel.  UTIs are awful.  If all it takes is cranberry juice….

Apr 16 2020

Watch out for Coronavirus frauds and unproven promises

Frauds and fraudulent information are so prevalent that the FDA says what it’s doing about them on its Coronavirus web page.

My email inbox is deluged with marketers claiming that their products boost immune systems in general, and protect against Coronavirus in particular.  Often, they cite evidence but this is highly selective and sometimes based on studies paid for by their sponsors.

The bottom line on keeping immune systems healthy?  Eat a healthful diet, don’t gain excess weight, and get plenty of physical activity.  OK, good luck doing that while you are under lockdown, but you can give it a good try.

Here are some of the items that have ended up in my inbox.

Despite FDA pronouncements, industry coalition action, the coronavirus claims warning letters keep coming:  The US Food and Drug Administration has issued an additional six warning letters in recent days on coronavirus claims. The letters coincide with an industry coalition raising a red flag on the growing flood of such claims on dietary supplement-type products….Read more

Unproven COVID-19 health claims: China’s crackdown on ads for oral sprays, probiotics and anti-hangover tea: The Chinese authorities have named and shamed a string of fake advertisement, mostly surrounding unproven COVID-19 health claims.

Consumers warned of sports nutrition products making coronavirus claimsThe European Specialist Sports Nutrition Alliance (ESSNA) has warned consumers of the increase in companies and individuals making unfounded claims in light of the current coronavirus situation….Read more

Cocoa and the coronavirus: can it boost the immune system?  Cacao beans have been consumed by humans for over 3,000 years and the ingredient is well-known for its wide range of health benefits, recent research suggests it can provide stronger protection against influenza virus infection…. Watch now [but watch critically.  If you even give this a moment’s thought….]

 

CRN UK highlights why essential nutrients have never been more essential:  The ongoing threat of coronavirus could increase the potential for deficiencies in key micronutrients supporting the immune system, according to The Council for Responsible Nutrition UK (CRN UK). Read more  [How about eating a healthy diet and getting plenty of exercise?].

Could vitamin D play a role in coronavirus resistance? Research thinks so:  Vitamin D supplements may aid in the resistance of respiratory infections such as the coronavirus or limit the severity of the illness in those infected, according to researchers. Read more.  [And what kind of research are we talking about here?  Some of it is industry-funded, as this example demonstrates (thanks to Claudia Santos for sending)].

Feb 24 2020

Industry-funded study of the week: collagen supplements

The study: A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind StudyNutrients 201911(10), 2494.

Purpose: “The purpose of this randomized, placebo-controlled, blind study was to investigate the effects of the drinkable nutraceutical ELASTEN® (QUIRIS Healthcare, Gütersloh, Germany) on skin aging and skin health.”

Conclusions: The test product significantly improved skin hydration, elasticity, roughness, and density…These positive effects were substantially retained during the follow-up.

Funding: This research was funded by Quiris Healthcare, Germany.

Conflicts of Interest: The authors declare no conflict of interest. The sponsor had no influence on execution, analysis and interpretation of the data.

Comment: The funder, Quiris Healthcare, “develops and sells innovative, natural health products. The focus is on effectiveness and special quality.”  What struck me about this particular example is how the authors report no conflict of interest and state that the sponsor had no influence on how the study was conducted, analyzed, and interpreted.  Most research on the influence of industry funding indicates that it most often shows up in the study design.  Research also shows that investigators are unaware of the influence; it occurs at an unconscious level.  I review data backing up these statements in my book Unsavory Truth: How Food Companies Skew the Science of What We Eat.

 

 

 

Feb 3 2020

Self-interested study of the week: Echinacea

Double-blind placebo controlled trial of the anxiolyticeffects of a standardized Echinacea extract.  József Haller,| Laszlo Krecsak| János Zámbori.  Phytotherapy Research.2019;1–9.

Conclusion: “These findings suggest that particular Echinacea preparations have significant beneficial effects on anxiety in humans.”

Conflict of interest statement: JH is one of the authors of a US patent on the anxiolytic effects Echinacea preparations.

Comment: I don’t usually bother to write about supplements because so little evidence supports their benefits over placebos.  This study finds small better-than-placebo benefits for this particular Echinacea supplement, presumably the one covered by the first author’s patent.  I’d be happier with independently funded research.  In the meantime, the European Food Safety Authority continues to have doubts.  Will this study make that agency change its collective mind?  We shall see.